A STEP-BY-STEP: Acne Treatment and Proper Extraction Protocol

Written by Lydia Sarfati

Acne treatment is one of the leading reasons clients seek out professional help. While skin care professionals do not diagnose or treat acne, they must be aware of this skin condition and know how to properly provide a facial. Performing consistent, effective facial treatments will not only benefit the client’s overall appearance, but will also help bolster their self-esteem. Both results are, perhaps, the most important achievements to which an aesthetician can aspire.

The following is a basic outline of a facial that incorporates deep cleansing, comedone extraction, and skin balancing treatments that will help oily, problematic skin get back on track to becoming a beautiful, healthy complexion.


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1. Cleanse skin using a soap-free formula that cleanses without causing dryness, preferably one that contains salicylic acid to gently exfoliate the skin.

2. Use a magnifying lamp to check for open pores, open and closed comedones, pustules, milia, or any redness or irritation.

3. 2 gifIf skin is irritated or sensitive, skip steaming. Otherwise, steam the face while applying a gentle skin serum that combines exfoliating ingredients with softening ingredients that help calm the appearance of the skin. This can be applied in gentle effleurage movements. This step, followed by a thorough desincrustation, is essential prior to extraction.

4. Soften the outmost layer of the skin before proceeding with extractions; this is because clients are often using dehydrating ingredients, such as hydrogen peroxide, on their skin at home to treat their acne. The professional will most likely find that while the skin is oily, the skin is extremely tight with dead skin cell accumulation. Even the sebum inside the pores is dried out and dehydrated! The client’s skin can be injured if blackheads are extracted in this state. The prep serum is the first step to softening the sebum to perform a gentle, but thorough, extraction. Remember, the clogging in the sebaceous gland is a kertinaceous plug. Keratin is a hard protein like hair. This keratin should be softened before extractions.

5. Desincrustation is a process of softening the keratinaceous horny plug to allow extractions to proceed easily with minimal trauma to the surrounding tissue. This can be achieved by using the proper desincrustation mask or gel. The efficacy can be increased when used in conjunction with galvanic current. (Please check with the local state board regarding use of galvanic and high frequency.) Desincrustation masks should soften and purify the skin. The mask can be left on for up to 10 minutes.

6. Administer a relaxing upper shoulder massage. Peel off the mask and remove residue with cotton and water. The skin has now been prepped for the extraction process.

7. Wearing a new pair of vinyl gloves, perform extractions (either manually or insert after or with cotton swabs) using a magnifying lamp. For manual extraction, wrap fingers with astringent gauze and exert firm pressure on the skin surrounding the comedone. Do not use the nails to squeeze, only the fingers. Apply slight pressure, alternating angles to gently lift the comedone from the follicle opening. Go section by section, starting at the chin. If cotton swabs are preferred, hold the swabs between the index finger and thumb, gently press down on both sides of the follicle, and move the swabs side to side. Do not apply too much pressure, as it can bruise the client’s skin. In both cases, if the contents are still not expelling, simply leave the comedone for the next treatment and proceed to the next area of concern. For removal of milia or pustules, use lancets. (Check with the local state board to see if it is permissible). Extractions should not take longer than 15 minutes.

8. Saturate cotton squares with astringent containing salicylic acid, a tea blend to soothe and hydrate skin. Do not rub the astringent in, but apply lightly, paying special attention to extraction areas. Applying astringent is critical after extractions, reducing the possibility of secondary infection and rehydrating the skin.

9. 3 gifFollow with a clay-based mask to help deep cleanse the pores while helping the skin feel soothed. Leave on for seven minutes and remove by applying warm, moist cotton over the entire face, letting it soak for a moment, then removing the mask in quick, gentle strokes. Remove any residue with astringent and cotton squares.

10. Follow with a calamine mask combined with tea extracts, zinc, and organic buttermilk powder to help reduce the appearance of erythema. Leave it on for 10 minutes.

11. Perform a relaxing hand massage. The client will appreciate it after the extractions! Afterward, remove the mask with wet cotton and warm water. Follow up with an astringent that helps tone the skin’s appearance. A client should never leave the salon with red, irritated skin after a facial treatment.

12. Apply a mattifying moisturizer that is formulated with zinc and squalane. It is key that the client’s skin is moisturized on completion of the facial treatment to further reduce dryness and the appearance of irritation.

13. 4 gifHigh frequency germicidal rays can be applied to the skin for faster healing time of lesions and prevent secondary infections. Starting at the chin, apply it in motions, moving over the entire face for a total of three to five minutes. Specific areas can also be targeted by lifting the electrode off of the skin. Follow local and state board laws regarding use of galvanic and high frequency devices and understand all possible contraindications.

Education and knowledge are key in helping clients with problem, oily skin. The client should be advised of the importance of spa treatments and following a unique homecare program to maintain the skin’s appearance between appointments. Discuss breaking bad habits, such as picking and squeezing the skin, as well as over-cleansing. A healthy diet should also be maintained, as well as avoidance of overexposure to ultraviolet light.

Experience has shown that proper treatment of oily, problem skin is critical to an aesthetician’s skill set, yet, once mastered, can be the key to business success. Spending time perfecting this critical technique can result in a strong, thriving client base!

Images courtesy of  Sarkli-Repechage, Ltd.  
© 2017 Sarkli-Repechage, Ltd.  All rights reserved.

5 gifLydia Sarfati is the founder and CEO of Repêchage, the first company to bring seaweed-based skin care treatments and cosmetics to the United States market. Sarfati is an international industry leader and the developer of the world-renowned Repêchage® Four Layer Facial®, what Cosmopolitan UK has called “the best facial of the century.” Today, together with her husband David Sarfati, co-founder and COO, Sarfati oversees a 50,000-square foot manufacturing, research, development, and training facility in Secaucus, New Jersey. She appears nationally and internationally at aesthetic trade shows, and attends and conducts overseas conferences in Asia, Europe, the Middle East, Central America, and South Africa.

“photos courtesy of Lydia Sarfati”

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